Ying Wan1, Ying Liu1, Wenjing Yang2, Xu Cui2. 1. Operation Center, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China. 2. Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China.
Abstract
OBJECTIVE: A prospective, randomized, and controlled study was conducted to investigate the effect of two-step jaw-thrust technique on the placement of flexible laryngeal mask (FLMA) with both hands. METHODS: Between November 2019 and January 2020, 160 patients scheduled for functional endoscopic sinus surgery with general anesthesia were enrolled in this study and were divided into two groups (n=80 each) using a random number table method: control group (group C) and test group (group T). After the induction of general anesthesia, the traditional method was applied to insert the flexible laryngeal airway mask in patients of group C, and the two-step jaw-thrust technique with both hands by the nurse was applied to help place the laryngeal mask in patients of group T. The success rate, alignment status by fibroscope (FOB) score, oropharyngeal leak pressure (OLP) of the laryngeal mask, oropharyngeal cavity soft tissue injury and postoperative sore throat, and the incidence of adverse airway event were compared between the two groups. (The registry of clinical trial: Chinese Clinical Trial Register, ChiCTR2100053017, https://www.chictr.org.cn). RESULTS: 78 patients in group C and 79 patients in group T were in includedfinal analysis. The success rates of the first placement of flexible laryngeal masks in patients of group C and group T were 73.81% and 97.52%, respectively. The final success rates were 97.52% and 98.81%, respectively. The success rate of first placement in group T was significantly higher than that of group C. There was no significant difference in the final success rate between the two groups (P=0.561). The alignment score showed that the placement of group T was significantly better than that of group C. The OLP of group T (25.43±3.82 cm) was significantly higher than that of group C (22.13±2.62 cm). The incidences of mucosal injury and postoperative sore throat in group T were 2.52% and 5.01%, which were significantly lower than those of 23.02% and 16.72% in group C. There was no adverse airway event in each group. CONCLUSION: The two-step jaw-thrust technique with both hands can improve the success rate of the first placement of the flexible laryngeal mask and the positioning of the laryngeal mask, increase the sealing pressure of the laryngeal mask, and reduce the incidence of oropharyngeal soft tissue injury and postoperative pharyngeal pain. AJTR
OBJECTIVE: A prospective, randomized, and controlled study was conducted to investigate the effect of two-step jaw-thrust technique on the placement of flexible laryngeal mask (FLMA) with both hands. METHODS: Between November 2019 and January 2020, 160 patients scheduled for functional endoscopic sinus surgery with general anesthesia were enrolled in this study and were divided into two groups (n=80 each) using a random number table method: control group (group C) and test group (group T). After the induction of general anesthesia, the traditional method was applied to insert the flexible laryngeal airway mask in patients of group C, and the two-step jaw-thrust technique with both hands by the nurse was applied to help place the laryngeal mask in patients of group T. The success rate, alignment status by fibroscope (FOB) score, oropharyngeal leak pressure (OLP) of the laryngeal mask, oropharyngeal cavity soft tissue injury and postoperative sore throat, and the incidence of adverse airway event were compared between the two groups. (The registry of clinical trial: Chinese Clinical Trial Register, ChiCTR2100053017, https://www.chictr.org.cn). RESULTS: 78 patients in group C and 79 patients in group T were in includedfinal analysis. The success rates of the first placement of flexible laryngeal masks in patients of group C and group T were 73.81% and 97.52%, respectively. The final success rates were 97.52% and 98.81%, respectively. The success rate of first placement in group T was significantly higher than that of group C. There was no significant difference in the final success rate between the two groups (P=0.561). The alignment score showed that the placement of group T was significantly better than that of group C. The OLP of group T (25.43±3.82 cm) was significantly higher than that of group C (22.13±2.62 cm). The incidences of mucosal injury and postoperative sore throat in group T were 2.52% and 5.01%, which were significantly lower than those of 23.02% and 16.72% in group C. There was no adverse airway event in each group. CONCLUSION: The two-step jaw-thrust technique with both hands can improve the success rate of the first placement of the flexible laryngeal mask and the positioning of the laryngeal mask, increase the sealing pressure of the laryngeal mask, and reduce the incidence of oropharyngeal soft tissue injury and postoperative pharyngeal pain. AJTR